Diabetes Management
An introductory guide for those who need it
In last week’s article, Understanding Diabetes, we outlined what diabetes is, the symptoms and risk factors to look out for, and if you should get screened. If you haven’t had a chance to check it out, you can access it here.
Diabetes is a non-communicable disease and while there is no cure, adopting consistent lifestyle changes can help improve your health and energy, keep your blood glucose, blood pressure, and lipids in the target ranges, and minimise the effects caused by diabetes (1). In this article we will look at how to implement these lifestyle changes to manage diabetes.
Timing of meals
As discussed in the previous article, ‘Breaking Down Sugars’, the type of food and how much you eat determines how high your blood glucose rises and how long it stays elevated. After eating a meal your glucose levels often hit their peak within 90 minutes, with the amount of time varying from 2–4 hours to return to normal (2).
Eating on a consistent meal schedule allows your blood sugars to remain stable and helps you have consistent energy throughout the day. When you go long periods between meals throughout the day you can notice blood sugar lows. Here are some tips to avoid experiencing blood sugar highs and lows.
- Aim to eat within one hour of waking. Try to have a substantial breakfast that has fibre, protein, and fats.
- Avoid going long gaps without eating during the day. Eat a meal every 4–5 hours. Have a snack between meals if you get hungry.
- If you are used to going long periods without eating, set an alarm on your phone to go off 4 hours after your last meal to remind you to eat something.
Glucose monitoring
Your meals, exercise, and medicine can affect your blood sugars, therefore it needs to be checked regularly. Typical times to check your blood sugar include when you first wake up, before a meal, two hours after a meal, and before bed. Monitoring your glucose is a great tool to use to become aware how various factors affect your blood glucose levels. Keep a log of your blood glucose readings with the time of the day and what you have eaten to see if you notice any trends occurring.
Hypoglycemia (low blood sugar) is defined as a blood glucose less than 70mg/dL. Diabetes does not cause hypoglycemia, however some medications used to treat diabetes lowers your blood glucose, causing hypoglycemia. If you delay or miss a meal, or are more active than usual, your chances of experiencing hypoglycemia are increased. When this happens you may experience a dip in energy levels, find it harder to concentrate, feel light-headed or shaky, or develop a headache (3).
If you have symptoms of hypoglycemia, test your blood glucose. If your blood glucose is less than 70mg/dL, have 15–20 grams of carbohydrates (4 glucose tablets, 15g of glucose gel, 4 ounces of juice, 1 tablespoon of sugar or honey). Test again after 15 minutes. If your blood glucose is still under 70mg/dL, re-treat with 15g of carbohydrates.
Hyperglycemia (high blood sugar) refers to when you have plenty of glucose in the bloodstream, but it can’t get into the cells. As the cells are unable to get the energy they need, it results in you feeling tired, drained, sad, low energy, and difficulty concentrating. High blood glucose can be due to changes in eating, lack of physical activity, and changes in medication. Having a cold of flu is a stress on the body that causes blood sugars to rise.
It’s important to consult your healthcare provider about what to do when your blood glucose is high as there are various factors which will determine how to treat it.
Physical activity
Exercise can naturally lower your blood glucose as being physically active requires energy, and glucose is our body’s primary source of energy. If you have diabetes, physical activity makes you more sensitive to insulin. The American Diabetes Association recommends at least 150 minutes/ week of moderate intensity aerobic physical activity distributed over 3 days (1). Below are some simple ways to boost your lifestyle activities:
- Go for an evening walk with a friend
- Ride a bike with your children
- Yard work, like gardening, weeding, or mowing your lawn
- With gyms being closed due to COVID restrictions, check out websites that offer exercise videos
- Include aerobic exercises to your day (climbing stairs, brisk walk, dancing, etc) . Start small and gradually increase your time.
Since exercise can have a powerful impact on your blood glucose, it’s important to be aware of the possibility of hypoglycemia. To minimise this risk, it is best to exercise after a light meal or snack. Make sure to check your blood glucose before you exercise. If it’s less than 100mg/dL, you may want to have a light snack such as a hard-boiled egg with a piece of whole wheat toast, or a piece of fruit with a handful of nuts.
What do I eat?
As discussed earlier, with diabetes, your body isn’t able to process glucose efficiently. Therefore it is necessary to be aware of the amount of carbohydrates you eat at each meal or snack so your body is able to process the amount of glucose without overwhelming your body. An easy way to ensure you’re eating balanced meals is to take a plate and divide it in half. Aim to fill one half of your plate with low-carbohydrate vegetables. Divide the other half of your plate in half again. In one quarter of the plate, put protein and in the other quarter is where your grains, starchy vegetables, fruits, and fruit juice, milk and yogurt will go.
As always, the key is to eat a variety of foods from the different food groups.
Low carbohydrate vegetables:
- Salad greens (lettuce, kale, spinach, swiss chard), beets, broccoli, carrots, cauliflower, celery, cucumbers, baigan, green beans, bodi, mushrooms, ochro, onions, christophine, sweet peppers, zucchini
Grains & starchy vegetables:
- Grains: ideally whole wheat rice, pasta, bread, oats, cereal, and crackers
- Starchy veg: peas, potatoes, squash, corn, ground provision
- Legumes: beans, lentils, peas
Protein:
- Lean meat
- Chicken or turkey without the skin
- Fish
- Eggs
- Nuts
The preparation of food is very important. Choose your protein which is grilled, broiled, or baked instead of fried, cream-based, or served with a lot of butter. Since diabetes can increase your risk of heart disease, it’s important to be aware of the type and how much fat you’re consuming. Replace your solid fats (butter, margarine) to liquid fats (olive oil, vegetable oil) when possible. Focus on unsaturated fats that promote heart health which are found in nuts and seeds, fish, and avocados (4).
Information this week by: Kirstyn Church, an Associate Nutritionist with Nutrition Consulting Services. Tru Valu Supermarket is one of the leading grocery chains in Trinidad and Tobago with five stores and the best customers. Have a question? Email us truvalusupermarkets@gmail.com.
References
1. American Diabetes Association. (2007). Nutrition Recommendations and Interventions for Diabetes. Diabetes Care .
2. Erickson, M. L., Jenkins, N. T., & McCully, K. K. (2017). Exercise after you eat: Hitting the postprandial glucose target. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2017.00228
3. Hypoglycemia (Low Blood sugar). (n.d.). American Diabetes Association. https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-c ontrol/hypoglycemia
4. National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Diabetes Diet, Eating, & Physical Activity. U.S. Department of Health and Human Services. https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activ ity
All of the content presented by Tru Valu Supermarkets on our Medium channel, including written text, photographs, videos, and graphics, as well as other resources we might include is meant to educate and it should not be perceived as a substitution for professional medical advice, as well as diagnosis or treatment. Always consult your doctor or nutrition advisor before making major lifestyle and diet changes.
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